Cost of Stroke in Australia From a Societal Perspective

Dewey, Helen M; Thrift, Amanda G; Mihalopoulos, Cathrine; Carter, Rob; Macdonell, Richard; McNeil, John J; Donnan, Geoffrey A.

doi:10.1161/hs1001.097222

Cited by 157 publications

(68 citation statements)

References 31 publications

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“…Other important categories were rehabilitation costs (16%), readmission costs (11%) and medication costs (9%). Australia: The direct lifetime costs following a first-ever stroke were also found to be twice those of the first-year costs of stroke in Australia, based on an incidence-based cost-of-illness model (16). In this study, the major drivers of the costs of stroke during the first year were acute hospitalization (28%), followed by inpatient rehabilitation (27%) and nursing home care (11%).…”

Section: Strokementioning

confidence: 63%

“…Ten studies estimating the cost of stroke (12,(15)(16)(17)(18)(19)(20)(21)(22)(23), of which three were Canadian studies and two were European reviews, were identified and are summarized in Table 2. Canada: Based on various public and private sources, the direct cost of stroke in Ontario was calculated to be at 2.7% of the total direct health care expenditures of Ontario (15).…”

Section: Strokementioning

confidence: 99%

“…Medications accounted for 2% of the costs. Indirect costs associated with loss of production were calculated to be 6% of the total first-year costs (16).…”

Section: Strokementioning

confidence: 99%

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Section: Strokementioning

confidence: 63%

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“…Indirect costs vary substantially between studies mainly because of differences in the mode of calculation. For example, it was estimated that indirect costs constituted 58 percent of total lifetime cost per person in the United States (27), 22 percent to 24 percent of the annual costs of stroke in the Netherlands and Sweden (8;28), and 6 percent of the first-year cost per patient in Australia (7).…”

mentioning

confidence: 99%

Cost of stroke in Sweden: An incidence estimate

Ghatnekar

Persson

Glader

et al. 2004

Int J Technol Assess Health Care

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Objectives:To estimate the excess cost of stroke in Sweden and the potential costs that could be avoided by preventing first-ever strokes. Methods: We adopted the incidence approach for estimating the present value of both direct and indirect costs. Data on mortality, stroke recurrence, and inpatient care were estimated from a national register of patient data with a four-year follow-up period. To estimate costs for social services, we used survey data on living conditions before stroke onset and at three and at twenty-four months. Costs for outpatient visits, rehabilitation, drugs, and production losses due to premature death and early retirement were estimated on the basis of both published and nonpublished sources. Lifetime costs were based on life tables adjusted for excess mortality of stroke, and costs in year 4 were extrapolated to subsequent years. Results: The present value direct cost for an average stroke patient is SEK513,800 (US$56,024 or Euro60,825). The corresponding indirect cost is SEK125,110 (US$13,640 or Euro14,810). Almost 45 percent of the direct costs were attributable to social services. Women had higher costs than men, and costs for survivors increased with age due to social services. Conclusions: With an incidence of 213 first-ever strokes per 100,000 individuals, the total excess direct and indirect cost of stroke would be SEK12.3 billion (approximately US$1.3 billion or Euro1.5 billion). Hence, there are large potential cost offsets both in the health-care sector and in the social service sector if the incidence of first-ever stroke could be reduced.

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“…2 It is a predictor of poorer outcome and need for residential care 3 , increased length of hospital stay 3 and 1-year and lifetime costs. 4 High-intensity dysphagia therapy yields favourable outcomes in acute stroke patients, with significantly fewer patients needing modified diets, dying or requiring residential care by 6 months post stroke. 5 Aims/Hypotheses: We sought to determine dysphagia incidence, prevalence at 7 days and dysphagia management practices of Speech Pathologists in Australian stroke units.…”

Section: Methodsmentioning

confidence: 99%

Concurrent 7

2008

Internal Medicine Journal

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with poor collaterals, p = 0.002). Correspondingly, most patients (11/16) with penumbra<66% had poor collateral status, versus 5/20 with penumbra > 66% (p = 0.02). Of the 15 patients with penumbra > 66% and good collateral status, eight had an excellent outcome (mRS 0-1) compared with 0/5 with penumbra > 66% and poor collaterals (p = 0.05).Ten of 15 patients with major reperfusion at 24-h had a good outcome, versus 2/21 without (p < 0.001). However, major reperfusion was predominantly beneficial in patients with good collateral status, 9/10 with good collaterals and major reperfusion had a good outcome, versus 1/5 with major reperfusion and poor collaterals (p = 0.008). Conclusion:Patients with a large penumbra have a high probability of good clinical outcome provided they also have good collateral status, and subsequent reperfusion occurs. Background and Aims: Transient ischemic attacks (TIA) may progress to a completed stroke. Opinion is divided on how best to prevent this in terms of admission versus an outpatient rapid assessment service for TIA evaluation. The ABCD score has been used to stratify TIA patients into high versus low risk of stroke progression. We aim to evaluate the utility of such a score. New Investigator Methods:A retrospective cross sectional study was conducted of consecutive admitted TIA patients in a Calendar Year (2006Year ( -2007.The ABCD score, length of hospital stay, progression to a completed stroke and other significant variables were recorded.Results: Eighty three TIA subjects (43 males) with a mean age of 75.3 ± 11.5 years were analysed. The median ABCD score was 5 (IQR = 4-5) with a mean length of stay of 4.1 ± 3.1 days. Four subjects (4%) progressed to ischemic stroke. No association between ABCD score and stroke progression was observed (p = 0.531). The presence of a carotid artery stenosis of >70% (p < 0.0001) and the absence of anti platelet use (p = 0.095) were associated with stroke progression post TIA. No haemorrhages were seen on CT brain scanning. Conclusion:No association was found between ABCD score and the risk of stroke progression which was low. Furthermore, hospital length of stay was relatively long. If a carotid Doppler could be performed on initial evaluation and anti platelet agents given following brain CT, then it is possible that TIA evaluation could be completed as an outpatient, avoiding the not inconsiderable costs of a hospital admission. Methods:We evaluated patients admitted to the Austin Hospital with SAH who underwent surgical clipping or endovascular coiling of an aneurysm and serial TCD monitoring. Vasospasm was defined as mean blood flow velocity (MV) ≥120 cm/s and Lindegaard ratio (LR) ≥3, and severe vasospasm as MV ≥200 cm/s and LR ≥6. The accuracy of TCD was determined by comparison of TCD with angiography performed within the same 24-h period. We also assessed whether the TCD detection of vasospasm triggered angiography within the next 48 h, and the time of onset of symptomatic vasospasm relative to TCD-detected vasospasm.Results: A total...

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Cost of Stroke in Australia From a Societal Perspective

Cited by 157 publications

References 31 publications

A review of the cost of cardiovascular disease

A review of the cost of cardiovascular disease

Cost of stroke in Sweden: An incidence estimate

Concurrent 7

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